Wednesday, December 21st

Wednesday’s campaign was a campaign for diabetes. In addition to testing for diabetes, two health professionals joined our team, one of which was a general practitioner. The other individual is currently in residency for pulmonary medicine. Both were great resources and educators.

We have been taught that in Peruvian culture trust is not easily obtained. As a result, one of the main goals in the clinic is to build trust with the community; this is essential to sustaining the clinic’s success over time. Many patients coming into the clinic are being exposed to medicinal procedures for the first time. It is important that their initial experience with medicine is positive. In Julia’s phlebotomy classes, they taught her techniques to make the needle and skin interaction as painless as possible. Implementing these techniques is one method that allows the clinic to build trust and create an atmosphere that patients will not fear returning to. Grace, a certified EMT that is on our team, was also able to offer techniques that can be applied in emergency situations. It was great to have two sets of information presented from highly competent teammates with prior hands on experience in drawing blood efficiently.

For the physical exams I got to scrub in on, there were not any concerns for any of the patients. Although the experience I've gained working with the worse cases is incredibly invaluable, it is always great when our patients come in and leave healthy. However, two severe cases were seen during the campaign. The first case was with an older lady who was battling bronchitis that she had contracted during a bout with tuberculosis. While this was a serious situation, I found the second case even more concerning.

The last patient of the day was a 15-month-old boy with a 42-year-old mother. The young boy could not walk, was unresponsive to verbal cues, and had a fever of 38.6 degrees Celsius (101.5 Fahrenheit). According to medical records, he has congenital heart failure, Down syndrome, and growth stagnation. The practitioner present gave the mother a prescription for medications. She warned the mother to take him to the hospital if his temperature had not fallen by the morning. This was a tough case for me to see. I had questions: what would happen next for this family? does the mother have access to a nearby pharmacy? I wanted to know what would happen in the case of a medical emergency: are there ambulances? is there a way for her to call an ambulance? how much of a financial burden is a trip in an ambulance? I hope we will see this mother and son again in the near future.

Today I also learned a lot about Peru’s healthcare and socioeconomic systems. Roughly 60% of Peru is on the government’s health insurance. On August 27th, 2016, Peru’s recently appointed minister of health, Dr. Patricia Garcia, made several statements in conjunction with APEC (Asia-Pacific Economic Cooperation) regarding changes she wants to make in Peru’s healthcare system. These adjustments would be an attempt to curb the ongoing depletion of healthcare funding due to the large population of Peruvians relying on the government’s monetary support for basic health needs to be met. For Dr. Garcia, her attention is on improving budget and workforce planning, resource allocation, and waste reduction to ensure quality care, in coordination with academia, business and industry organizations. Developing and sharing data to drive policy innovation, effective physical and mental health interventions by practitioners, and reliable impact measurements is a further point of emphasis. (Read more about this here)

Katie told us that the majority of Peruvians living in the slums drop out of school between 3rd and 5th grade. These individuals do not have the opportunity to learn the scientific academia that students in the United States’ education system take for granted. At the clinic, each patient is surveyed to assess his or her current health situation. When this data accumulates over several years, the clinic will have quantitative data measuring the difference certain programs are making on certain health disparities.

The average salary of an individual in the slums across Peru is 300 sols per month. This equates to less than $100 per month, or $1200 per year for an impoverished Peruvian’s average annual salary. In 2016 the United States’ federal government placed any family of 2 earning below $16,020 in poverty. (More information on these statistics can be found here) Relatively speaking, an impoverished American citizen would be doing extremely well in Peru.

After we were finished at the clinic for the day, we went back to our host family’s house for lunch. Then we went to a traditional Peruvian horse show, where the girls and Piero rode the horses after the show. Afterwards we went to get ice cream and materials to make posters. We spent the rest of the afternoon making educational posters to display on the walls of the clinic. After dinner, which was served by our host families, we spent the rest of our evening with Katie’s Peruvian best friend, Lorenzo.